BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  ACR 155
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          Date of Hearing:   June 17, 2014

                            ASSEMBLY COMMITTEE ON HEALTH
                                 Richard Pan, Chair
                  ACR 155 (Bocanegra) - As Introduced:  May 28, 2014
           
          SUBJECT  :  Childhood brain development: adverse experiences:  
          toxic stress.

           SUMMARY  :  Urges the Governor to identify evidence-based  
          solutions to reduce children's exposure to adverse childhood  
          experiences (ACEs), address the impacts of those experiences,  
          and invest in preventive health care, mental health and,  
          wellness interventions.  Specifically,  this resolution  :

          1)Makes legislative findings and declarations related to adverse  
            experiences and toxic stress, including:

             a)   Experiences in the first few years of life build changes  
               into the biology of the human body that influence the  
               person's physical and mental health over his or her  
               lifetime;

             b)   ACEs are traumatic experiences that occur during  
               childhood, including the following:
               i)     Physical, emotional or sexual abuse;
               ii)    Physical and emotional neglect;
               iii)   Household dysfunction, including substance abuse,  
                 untreated mental illness, or incarceration of a household  
                 member; and,
               iv)    Domestic violence, or separation or divorce  
                 involving household members.

             c)   Researchers found that a person with four or more ACEs  
               was more likely to have adverse health effects;

             d)   Strong, frequent, or prolonged stress in childhood  
               caused by ACEs can become toxic stress, impacting the  
               development of a child's fundamental brain architecture and  
               stress response systems; and,

             e)   The emerging science and research on toxic stress and  
               ACEs evidence a growing public health crisis for the state  
               with implications for the state's educational, juvenile  
               justice, criminal justice, and public health systems.








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          2)Urges the Governor to reduce childrens' exposure to ACEs,  
            address the impacts of those experiences, and invest in  
            preventive health care and mental health and wellness  
            interventions.

          3)Urges the Governor to consider the principles of brain  
            development, the intimate connection between mental and  
            physical health, the concepts of toxic stress, ACEs, buffering  
            relationships, and the roles of early intervention and  
            investment in children as important strategies.

           FISCAL EFFECT  :   None
           

          COMMENTS  :

           1)PURPOSE OF THIS BILL  .  The author states that the concepts of  
            ACEs and toxic stress are relatively new, and are not yet part  
            of the lexicon of parents, community members, and  
            policymakers.  While there is still much to be learned, the  
            findings are irrefutable:  toxic stress caused by ACEs can  
            profoundly alter the otherwise healthy development of a child.  
             The author further states that ACEs can literally shape the  
            physical architecture of a child's developing brain and can  
            weaken the foundation for the learning, health, and behavior  
            that follows.  As a result of ACEs, toxic stress - the  
            prolonged activation of the stress response - often occurs,  
            inducing a disruption in a child's brain architecture and  
            other organ systems.  The outcome is a lifetime of health  
            consequences, from difficulty concentrating in school to heart  
            disease and diabetes - leading to inflated costs for the  
            state's juvenile justice, criminal justice, health care, and  
            public health systems.

           2)BACKGROUND  .  The federal Centers for Disease Control and  
            Prevention and Kaiser Permanente's Health Appraisal Clinic in  
            San Diego are conducting an ongoing study called the Adverse  
            Childhood Experiences Study (ACE Study).  The ACE Study is one  
            of the largest investigations ever conducted to assess  
            associations between childhood maltreatment and later-life  
            health and well-being.  The study has found the following:

             a)   A child with four or more ACEs is 32.6 times as likely  
               to have a learning or emotional problem;








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             b)   A strong correlation exists between the number of ACEs  
               and a person's risk for disease and negative health  
               behaviors; and,

             c)   A person with four or more ACEs is 2.4 times as likely  
               to have a stroke, 1.9 times as likely to have cancer, 10.3  
               times as likely to use injection drugs, and 7.4 times as  
               likely to be an alcoholic.

           3)SUPPORT  .  According to the Child Abuse Prevention Center,  
            stressful or traumatic childhood experiences are a common  
            pathway to social, emotional, and cognitive impairments that  
            lead to increased risk of unhealthy behaviors, risk of  
            violence or revictimization, disease, disability and premature  
            mortality. By investing in detection, prevention, and  
            treatment California can improve the life changes of millions  
            of youth and families and build strong, healthy, and safe  
            communities for generations to come.
             
             The Lawyers' Committee for Civil Rights of the San Francisco  
            Bay Area state that far too often, the stressors in our  
            children's lives go unnoticed and unaddressed.  The outcome is  
            a lifetime of health consequences, from difficulty  
            concentrating in school to heart disease and diabetes -  
            leading to inflated costs for the state's juvenile justice,  
            criminal justice, health care, and public health systems.

           4)RELATED LEGISLATION  .  SB 899 (Mitchell) deletes California's  
            Maximum Family Grant rule, which prohibits CalWORKs payments  
            from being made on behalf of children who were conceived after  
            a family begins receiving aid except in cases of rape, incest,  
            or contraception failure, as specified.  SB 899 also makes  
            legislative findings indicating that the toxic stress of deep  
            poverty can lead to lifelong cognitive impairments.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 
           
          Alliance for Boys and Men of Color
          American Academy of Pediatrics, District IX 
          American Civil Liberties Union of California
          California Alliance of Child and Family Services
          California Family Resource Association








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          Californians for Safety and Justice
          California Pan-Ethnic Health Network
          California School-Based Health Alliance
          Center for Youth Wellness
          The Child Abuse Prevention Center
          Children NOW
          Coleman Advocates for Children & Youth
          Crittenton Services for Children and Families
          David Lynch Foundation
          First 5 Association of California
          First 5 Alameda County
          Lawyers' Committee for Civil Rights of the San Francisco Bay  
          Area
          National Compadres Network
          PolicyLink
          Public Advocates
          Public Counsel
          Southeast Asia Resource Action Center
          Youth Alive!
          Zero to Three National Center for Infants, Toddlers, and  
          Families

           Opposition 
           
          None on file.
           
          Analysis Prepared by  :    Paula Villescaz / HEALTH / (916)  
          319-2097